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Seishin Igaku Volume 43, Issue 3 （March 2001）

精神医学 43巻3号（2001年3月発行）

Japanese English

研究と報告

Propranololの併用により焦燥感や攻撃性および暴力行為が軽減した慢性精神分裂病の2症例 Propranolol as an Effective Agent for the Treatment of Agitation, Aggression and Violent Behavior in Two Inpatients with Chronic Schizophrenia 谷川真道 ^1,2 , 小渡敬 ¹ , 金城みづえ ¹ , 宮城則孝 ^1,2 , 榎木宏之 ¹ , 小渡皐月 ¹ Masamichi TANIGAWA ^1,2 , Satoshi ODO ¹ , Mizue KINJO ¹ , Noritaka MIYAGI ^1,2 , Hiroyuki ENOKI ¹ , Satsuki ODO ¹ ¹平和病院 ²琉球大学医学部精神神経科学講座 ¹Department of Psychiatry, Heiwa Hospital ²Department of Neuropsychiatry, Faculty of Medicine, University of the Ryukyus キーワード： β-blockers , Propranolol , Agitation , Aggression , Violent behavior , Schizophrenia , The Overt Aggression Scale , OAS , The Overt Agitation Severity Scale , OASS Keyword: β-blockers , Propranolol , Agitation , Aggression , Violent behavior , Schizophrenia , The Overt Aggression Scale , OAS , The Overt Agitation Severity Scale , OASS pp.299-306

発行日 2001年3月15日 Published Date 2001/3/15

DOI https://doi.org/10.11477/mf.1405902391

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Abstract 文献概要
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【抄録】　Propranololをはじめとするβ) blockersは，不安障害（パニック障害，社会恐怖など），リチウム起因性振戦，薬剤性アカシジア，遅発性ジスキネジア，PTSDなどの治療に有効と報告されており，さらに欧米においては精神分裂病者，精神発達遅滞者，痴呆性疾患や外傷などの器質性精神障害者の焦燥感，攻撃性および暴力行為などの症状の治療薬として，いくつかの報告がみられている。今回我々は，向精神薬の副作用により，向精神薬の増量や追加が難しく，焦燥感，攻撃性および暴力行為がみられていた精神分裂病の2症例にpropranololを併用したところ，低血圧や徐脈などを認めることなく，症状の軽減が認められた。なお，焦燥感の評価にはThe Overt Agitation Severity Scale（OASS），攻撃性の評価にはThe Overt Aggression Scale（OAS）を用いた。propranololは，焦燥感や攻撃性，暴力行為が認められる精神分裂病者で，向精神薬の増量や追加が困難な症例においては，有効な薬剤の1つであると考えられた。

　Introduction : Propranolol is commonly used in medical practice for the treatment of hypertension, angina, and certain cardiac arrhythmias. Although propranolol is not officially approved for use in psychiatric indications, some studies show that they are effective in generalized anxiety disorders, neuroleptic-induced akathisia, lith-iuminduced postural tremor, withdrawal symptoms, agitation, aggression and violent behaviorrelated disorders in patients with chronic schizophrenia, brain injury and mental retardation.

　Method and Subjects : The subject's symptoms (i.e., agitation, aggression and violent behavior) were evaluated by a doctor and several nurses using The Overt Aggression Scale (OAS) and The Overt Agitation Severity Scale (OASS). Both scales are objective measurements.

　Subjects were two inpatients with chronic schizophrenia who required the prescription of additional antipsychotic agents due to unstable symptoms, but adverse effects emerged and their ADL (“activity of daily living”) worsened. Propranolol was substituted and their symptoms improved at a dose of 90~120mg/day. The subject's OASS scores and OAS scores improved as well.

　Conclusion : Propranolol was an effective agent for the treatment of agitation, aggression and violent behavior in two inpatients with chronic schizophrenia. This study showed that propranolol is a useful agent to lessen agitation, aggression and violent behavior without adverse effects such as general sedation, extrapyramidal symptoms, and anticholinergic effects. Clinicians should be aware that propranolol is one of effective agents in psychiatric practice as well as in cardiac practice.